ACKNOWLEDGMENT OF RISK

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1 -AUTO SKILLS CENTER- IMPORTANT: THIS IS A LEGAL DOCUMENT Please read and understand this document before signing. If you have any questions, please ask us or consult an attorney. Navy Morale, Welfare and Recreation (MWR) Department and the Navy Automotive Skills Program provide automotive craft enthusiasts with a quality, value-based program for the repair and maintenance of their privately-owned vehicles. Navy MWR Auto Skills Centers are not full service stations. They are facilities where patron self help is fostered and automotive skills are learned. Guidance wherever necessary is provided from trained automotive skills staff personnel. However, we wish to inform our patrons that there are risks associated with automobile skill centers. We do not want to heighten or reduce your enthusiasm for the experience, but we do want you to know in advance what to expect and to be informed of some of the possible risks. We ask that you read, sign, and return this document to our office before you are authorized to use any Navy MWR spaces or equipment. ACKNOWLEDGMENT OF RISK The Navy MWR Auto Skills Program typically includes Brakes and Tire Repairs, Minor Engine Tune-up, Oil and Lube Services, Muffler Repair, Minor Body Repair, and Body Paint Touch-up. There are always risks associated with working on automobiles. Use common sense when making inspections and repairs. Know how to fix an element before you begin and then work efficiently. When paint booths are offered at Navy MWR Auto Skills Centers, the process of spray painting may result in increased exposure to hazardous substances. You may be exposed to vapors, dust, paint mists (aerosols) and solvents used in the clean up process. The route of entry to the body is generally through inhalation of dust or aerosols; however, there is also potential exposure through swallowing. Exposure to hazardous substances may cause acute or chronic health effects, to include but not limited to, respiratory tract irritation, shortness of breath, dizziness, dehydration, heat exhaustion, heat stroke, heat cramps, influenza-like symptoms, tightness of the chest, nausea, headaches, cancer, sensitization of the respiratory system, asthma, abnormal reduction in lung function, emphysema, central nervous system dysfunction and death. Exposure of the skin and eyes to hazardous substances may result from the presence of airborne paint mist (aerosol) or dust, or through direct contact with paint or freshly painted surfaces. The health effect in these circumstances may be acute burning of the eyes. Skin contact with paint and solvents may result in acute irritant dermatitis, chronic allergic contact dermatitis, or damage to the skin. When working underneath any part of the car, it is absolutely necessary to use a hydraulic lift or a jack to raise your car off the ground, either to get the wheels off the ground or to get room to work under the car. Be sure the jack stand is rated to support the weight of the car. However, when using a hydraulic lift or a jack to raise your automobile, a variety of risks, foreseen or unforeseen, including, but not limited to temporary or permanent risks of eye injuries; bruises; burns; cuts from sharp objects and edges; head, neck, or spinal injuries; loss of use of arms and/or legs; disfigurement; total paralysis; or even death if you are not careful. Additionally, your automobile may fall off the hydraulic lift or jack and become damaged. There are many precautions that should be observed when using tools at the Navy MWR Auto Skills Center Naples Italy Support Activity: (1) Files should never be used without a handle, because there is always the danger of running the point into the palm of the hand. Files should not be used as levers or hammers. Files are made with hard temper and are quite brittle, so if hammered, small pieces may fly off and cause severe wounds or loss of eyesight. (2) Hammers or sledges should be checked to see that the head is attached securely so that it doesn't fly off when the tool is used. (3) When the head of a chisel is mushroomed, it should be thrown away or reground to prevent bits of steel from flying off and causing damage. A shield or helmet should always be worn

2 when grinding. (4) Pull on the handle of a wrench, rather than pushing on it to prevent the danger of skinning the knuckles. When the jaws of the wrench become worn or sprung, the tool should be disposed of. (5) When using power tools, electric shock or electrocution can occur if not properly used or not regularly maintained. Static electricity charges can be generated in any spray painting process where two differently charged materials come into contact. A static electrical charge can be enough to ignite flammable materials. Car batteries contain sulfuric acid, which can burn. They also emit hydrogen gas, which may explode. Wear gloves while working around a battery and do not smoke near it. Car batteries can give electrical shocks and are a fire hazard. Disconnect the battery while working on the fuel line or electrical system. It is only necessary to remove the ground cable, which is easily identified by a black mark or a minus (-) sign on the battery casing at the terminal. Radiator hoses, exhaust pipes, manifolds, and mufflers can be very hot to the touch. Allow time for these parts to cool off before working on the car. If there is some reason that you can't wait, wear heavy gloves and be very careful. DO NOT remove the radiator cap in one turn. Turn it slowly to half off and allow the steam to escape. Always use gloves or a rag. When the steam has escaped, turn the cap off fully. Always keep your face turned away from the radiator cap. Slipping on oil, gasoline, or other leaking fluids can cause serious injuries. To prevent slipping, wipe up all spills immediately. Be particularly careful when wiping up flammable or chemical fluids. Gasoline, brake fluid, and certain cleaning fluids used in repairing an automobile needs special precautions to prevent fire. Fuel, thinner and other combustibles should always be kept in closed containers designed for the purpose; they should also be well marked and stored safely. Smoking and unshielded flames should always be avoided while working on a car. As a further protection against fire, oil and grease rags should also be kept in containers; use care, however, that spontaneous combustion does not occur. DO NOT point an air gun in the direction of anyone, because the high pressure can blow dirt particles at such high speed that they will puncture the skin and/or get in the eyes. Loose clothing can easily be pulled into moving machinery parts. A loose shirt cuff, necktie, dangling jewelry, frilled blouses, or long hair can all be pulled into a moving part while making repairs. Be sure to remove such hazards. Caps without brims are considered safer than those with brims, and it is advisable to wear a sturdy pair of shoes or boots to protect the feet. I understand that I must exercise particular caution when using the Navy MWR Auto Skills Center Naples Italy Support Activity, and especially when using power tools, non-electrical tools, automotive equipment, paint booths, hydraulic lifts, etc., to make repairs to my automobile. I further understand that I may be subjected to a variety of hazards and risks, foreseen or unforeseen, including, but not limited to temporary or permanent sprains; strains; cuts; burns; abrasions; bruises; ligament and/or cartilage damage; head, neck, or spinal injuries; loss of use of arms and/or legs; eye damage; disfigurement; total paralysis; or even death. I voluntarily assume the risks I may incur while performing automotive maintenance at Navy MWR Auto Skills Center Naples Italy Support Activity. Because Navy MWR Auto Skills Center Naples Italy Support Activity makes these services available at a discounted rate, as such, I agree that terms of this release shall cover any injury I receive due to an accident on the part of Navy MWR Department Naples Italy Support Activity whether by their negligence or the negligence of others. This list is not an exclusive or exhaustive list of possible injuries, trauma, or accidents that may occur while performing automotive repairs at the Navy MWR Auto Skills Center Naples Italy Support Activity. Most of these injuries are rare and you are not likely to encounter them. However, they have occurred, and you need to know about them and other possible injuries not mentioned above.

3 CONTRACT, WAIVER, RELEASE AND INDEMNIFICATION I certify that I am fully capable of making repairs to my automobile at the Navy MWR Auto Skills Center. I state that I have read the above statement on some of the possible risks associated with the Navy MWR Automotive Skills Program. Therefore, I assume full responsibility for myself, my family, (including minor children), for bodily injury, death and loss of personal property, and any expenses as a result of my negligence, negligence of my family, negligence of another patron at the Navy MWR Automotive Skills Program, or the negligence of Navy MWR Auto Skills Center Naples Italy Support Activity staff. I also understand that Navy MWR Department Naples Italy Support Activity reserves the right to refuse any person it judges to be incapable of meeting the rigors and requirements for performing automotive repairs at the Navy MWR Auto Skills Center. My family and I are in good physical condition and able to undertake this activity. I agree to indemnify and hold harmless Navy MWR, Navy MWR Department Naples Italy Support Activity, Naples Italy Naval Station and its staff, and the U.S. Navy, and its members, agents and employees from all claims, damages, losses, injuries and expenses arising out of or resulting from the automotive repairs performed to my vehicle. I further agree to release, acquit, and covenant not to sue Navy MWR, Navy MWR Department Naples Italy Support Activity, Naples Italy Support Activity and its staff, and the U.S. Navy, and its members, agents and employees for all actions, causes of action claims or damages, damages in law or remedies in equity of whatever kind, including the negligence of Navy MWR Naples Italy Support Activity, its staff or my family, myself, or my heirs, against Navy MWR Department Naples Italy Support Activity arising out of my participation in the Navy MWR Automotive Skills Program. In short, I cannot sue Navy MWR, Navy MWR Department Naples Italy Support Activity, Naples Italy Support Activity and its staff, and the U.S. Navy, and its members, agents and employees, and if I do, I cannot collect any money. I agree to the site of any lawsuit and the law governing any such lawsuit shall be governed by the Federal Tort Claims Act, Military Claims Act, Foreign Claims Act, Suits in Admiralty Act, Public Vessels Act or Admiralty Extension Act, whichever is applicable. The terms of this agreement shall continue and be in effect after I have left the Navy MWR Auto Skills Center. I hereby give permission for transportation to any medical facility or hospital and I authorize any MWR employees, or medical personnel to render necessary emergency medical care for my family or me. I hereby authorize the release of any medical information, including information concerning any possible HIV or AIDS status, in the possession of Navy MWR Department Support Activity to any medical facility or hospital, ambulance, first aid provider, first aid service, doctor, nurse or other such person rendering care on my behalf. I hereby waive any action or claim against Navy MWR Department Naples Italy Support Activity and its staff or any health care provider, hospital, doctor, nurse, or first aid provider for the release of this medical information including my HIV or AIDS status. As liquidated damages, I hereby agree that if Navy MWR, Navy MWR Department Naples Italy Support Activity, Naples Italy Support Activity and its staff, and the U.S. Navy, and its members, agents and employees are forced to defend any action, lawsuit or litigation by myself, my executors, or my heirs, on my family's or my behalf; accordingly, my heirs or executors and I agree to pay court costs and attorney fees if they successfully defend such action, lawsuit or litigation. Should a court of competent jurisdiction declare any paragraph or part of this agreement enforceable, the remaining parts or paragraphs shall remain in full force and effect. I authorize and release to Navy MWR Department Naples Italy Support Activity and its staff the use of my image in any photograph or video recording for any purpose of Navy MWR Department Naples Italy Support Activity. I have adequate health, disability and life insurance for my family and myself.

4 I,, of my own free will, for my family, my minor children, my heirs and executors and myself, have read, understand and acknowledge the risks and liability for myself and my family this day of 20. I have read and understood this agreement. FIRST PARTICIPANT SIGNATURE SECOND PARTICIPANT SIGNATURE PRINTED NAME PRINTED NAME ADDRESS THIRD PARTICIPANT SIGNATURE PRINTED NAME PHONE: [ ] IN CASE OF EMERGENCY PLEASE CONTACT: PHONE: I CARRY MEDICAL INSURANCE. YES NO GROUP NUMBER: NAME OF PROVIDER:

5 AUTO SKILLS CENTER PATRON QUIZ Read questions carefully and circle true or false. 1. Metal parts should be disposed of in the blue recycle bin TRUE FALSE 2. Safety glasses must be worn when performing potentially hazardous tasks. TRUE FALSE 3. Compressed air for cleaning purposes should be regulated To a pressure less than 30PSI and NEVER used for cleaning clothing. TRUE FALSE 4. The tool rest should be positioned no more than 1/8 inch from the TRUE FALSE grinder s wheel and ¼ inch from the tongue guard. 5. Patrons are responsible cleaning the stall, lift and work area when work is complete. TRUE FALSE 6. There is NO need to turn the lift s power off once the vehicle is at it s desired height. TRUE FALSE 7. A safe precaution is reading the safety instructions located on the lift, TRUE FALSE near the power switches, prior to using it. 8. Hydraulic jacks are the only safety device needed when working TRUE FALSE under vehicles. 9. Patrons do NOT need their car guided on the lift by a hobby shop TRUE FALSE employee. 10. Organic solvent can damage the central nervous system and TRUE FALSE cause lack of coordination and drowsiness or even damage to blood, lungs, kidneys and digestive system. 11. Patrons should dispose of their empty oil containers in the TRUE FALSE wastebasket located at the work bays. 12. Welding operations shall only be permitted by patrons TRUE FALSE who are certified. 13. Children under 14 years of age are not allowed in the TRUE FALSE auto Hobby Shop. 14. To prevent a serious accident, always use jack stands under vehicles with hydraulic jacks. Refer to your owner s manual for TRUE FALSE specific locations of placement for your vehicle. 15. Smoking in the shop area is permitted. TRUE FALSE 16. Goggles, gloves and an apron will be worn when using TRUE FALSE solvents such as parts and brake cleaners. 17. All USED rags must be turned into the tool room. TRUE FALSE 18. A bench or pedestal grinder must have safety guards which TRUE FALSE cover at least ¾ of the outside of the wheel. 19. Symptoms of overexposure to carbon monoxide include TRUE FALSE

6 a dull headache, dizziness, ringing in the ears, nausea and pounding of the heart. 20. Hearing protection is required when using equipment designated as noise hazardous (i.e. Tire changer, pneumatic tools). TRUE FALSE 21. You must be safety briefed prior to pulling onto, or operating the lifts. TRUE FALSE 22. After brake work you must have your vehicle checked by TRUE FALSE a shop attendant before leaving the facility. 23. All used oil is to be taken the storage out back. TRUE FALSE 24. Open toed shoes are allowed in the work bays. TRUE FALSE OIL SALE REGULATION: YOU CAN PURCHASE OIL FROM OUR FACILITY FOR OIL CHANGES OR TO TOP OFF YOUR CAR. YOU CANNOT, UNDER ANY CIRCUMSTANCE, TAKE THE OIL OUT OF OUR FACILITY. OIL THAT IS PURCHASED HERE MUST BE USED HERE. We also require a copy of your MVRO registration. Only the owner and spouse may purchase oil for that vehicle. Please print your name LEGIBLY, sign and write you PRD date. Customer s name (Print legibly) Customer s signature PRD Date (Date you will leave this command)